Poliovirus was discovered in sewage from North and East London

The United Kingdom’s Health Safety Agency (UKHSA), working with the Medicines and Healthcare Products Regulatory Agency (MHRA), has found poliovirus in sewage samples collected from the London Beckton Sewage Works.

As part of routine surveillance, it is normal for 1 to 3 ‘vaccine-like’ polioviruses to be detected each year in UK sewage samples, but these have always been sporadic findings that have not been detected again. These earlier discoveries occurred when an individual vaccinated overseas with live oral polio vaccine (OPV) returned or traveled to the UK and briefly ‘shed’ vaccine-like traces of poliovirus in their faeces.

Investigations are underway after several closely related viruses were found in sewage samples taken between February and May. The virus has continued to evolve and is now classified as a ‘vaccine-derived’ type 2 poliovirus (VDPV2), which in rare cases can cause serious illness, such as paralysis, in people who are not fully vaccinated.

The discovery of one VDPV2 suggests that there is likely to have been some spread between closely related individuals in North and East London and that they are now shedding type 2 poliovirus in their faeces. The virus has only been detected in sewage samples and no associated cases of paralysis have been reported – but investigations will aim to establish whether any community transmission is taking place.

The last case of wild polio contracted in the UK was confirmed in 1984. The UK was declared polio-free in 2003.

Dr Vanessa Saliba, Epidemiological Consultant at UKHSA said:

Vaccine-derived poliovirus is rare and the risk to the general public is extremely low.

Vaccine-derived poliovirus has the potential to spread, especially in communities where vaccine uptake is lower. In rare cases it can cause paralysis in people who are not fully vaccinated, so if you or your child are not up to date with their polio vaccinations, it is important to contact your GP to catch up or if you are not you are sure, check the Red Book. Most of the UK population will be protected by childhood vaccination, but in some communities with low vaccine coverage, individuals may remain at risk.

We are urgently investigating to better understand the extent of this transmission and the NHS has been asked to rapidly report any suspected cases to UKHSAalthough no cases have been reported or confirmed so far.

Jane Clegg, chief nurse for NHS London said:

Most Londoners are fully protected against Polio and will not need to take any further action, but the NHS will start contacting parents of children aged under 5 in London who are not up to date with polio vaccines. them to Polio to invite them to protect you.

Meanwhile, parents can also check their child’s vaccination status in the Red Book and people should contact their GP to book a vaccination if they or their child are not fully up to date.

The United Kingdom is considered by the World Health Organization to be polio-free, with a low risk of polio transmission due to the high level of vaccination coverage across the population. However, vaccination coverage for childhood vaccines has fallen nationally and particularly in parts of London over recent years, so UKHSA is urging people to check they are up to date with their vaccinations.

Wastewater surveillance is being expanded to assess the extent of transmission and identify local areas for targeted action. Health care professionals have been alerted to these findings so they can immediately investigate and report anyone presenting with symptoms that could be polio, such as paralysis.

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